Delays in school support are harming children in Wales, survey finds

Fewer children in Wales would be absent from school if they had earlier access to school-based occupational therapy, a survey has found.

The Royal College of Occupational Therapists (RCOT) released the findings, gathered following an online survey of 527 occupational therapists from 2 February to 2 March 2026, as part of its Right Support, Right Time campaign.

Occupational therapists work across health, social care, education and private practice with adults and children of all ages who have a wide range of conditions, helping them overcome challenges when completing everyday tasks or activities, also known as occupations. 

There are currently around 200 occupational therapists who work with children with nearly 1500 mainstream schools in Wales, though not all are based in schools.

However, despite the role occupational therapy plays in helping children participate in the classroom, develop essential skills and manage emotions, nearly nine in ten respondents (89%) said a shortage of occupational therapy capacity is now a major barrier to effective Additional Learning Needs (ALN) support in their area.  

As a result, children are missing out on essential support with things like learning how to do up zips, hold a pen, use a knife and fork, or go to the toilet by themselves.

Children with sensory differences may not be included in classroom tasks if the lighting or sound levels haven’t been adjusted, and children who struggle with mobility may not be able to get to certain parts of their school.

According to RCOT there is “a desperate need” for an increase in the number of occupational therapists and a shift in resources to ensure every school in Wales has access to the support its pupils need.

The survey found that the top five areas that are most impacted by delays in accessing occupational therapy for children and young people attending mainstream schools across the UK are:

• Emotional distress/anxiety for the young person (90%)
• Reduced participation in learning activities (89%)
• Emotional distress/anxiety for parents/caregivers (88%)
• Delayed development of essential skills such as handwriting and self-care (87%)
• Increased pressure on teachers and other school staff (81%)

In the 2024/25 academic year, the overall absence rate for children with ALN in Wales was 11.1%, compared to 6.9% for all children in primary schools, and 17.7% compared to 10.1% in secondary schools. 

RCOT says that with more inclusive practices in mainstream schools, driven by occupational therapists, this gap could be reduced.

According to RCOT members, the top five benefits and improvements of getting the right support from occupational therapists at the right time are:

• Classroom participation (92%) 
• Ability of caregivers/parents to support their child’s needs (90%) 
• Behaviour and emotional regulation (86%) 
• Capacity of school staff to support children and young people (85%) 
• Mental health and wellbeing, e.g. confidence, self-esteem (83%) 

More than half of respondents (56%) said they’re unable to provide the level or type of support children in their area need and only around two in five (39%) said their occupational therapy teams are fully staffed. 

The survey also revealed that nine in 10 (90%) respondents believe earlier occupational therapy could prevent the need for an Individual Development Plan (IDP), either almost always or sometimes.

Over nine in 10 (92%) respondents believe improving access to school‑based occupational therapy could reduce the number of ALN tribunals, supporting both families and overstretched local systems.

Policy and Public Affairs Lead for Wales at the Royal College of Occupational Therapists, Paul Smith, said: “Every child in Wales deserves a fair chance to learn and achieve, but our survey highlights the serious impact of long waits for occupational therapy.

“Too many children and young people in Wales are left without help that could make school easier and more positive. And we know that getting the right support earlier can help not only pupils, but teachers and other staff too.

“While waiting, children can become frustrated, anxious and fall behind in their learning and development, which is why an integrated, whole-school approach is essential. Early intervention works best, but our members have told us they don’t have the time or resources to meet demand.

“Occupational therapists help children take part in school and build skills for the future, including improving their chances of employment. Without the right occupational therapy workforce in Wales, children face preventable challenges that could last a lifetime.” 

By working in partnership with schools, occupational therapists can identify children’s needs early and provide timely support to stop difficulties from escalating.

Early support for children who have experienced trauma improves outcomes in the classroom, enabling teachers to teach and students to thrive.

As such, RCOT is calling for every mainstream school in Wales and across the rest of the UK to have access to occupational therapy expertise and to take a whole-school approach to providing support.

Adopting this approach and enabling school staff to identify, support and include learners with additional needs will mean occupational therapists have more time to focus on children and young people with higher support needs.

To achieve this, investment in the occupational therapy workforce is “essential”, as well as integrated commissioning of children’s occupational therapy services.

RCOT has also called for better integration across education, health and care to ensure children and young people get the support they need to learn and thrive at school. 

More information about the Right Support, Right Time: Unlocking the Power of OT campaign is available here.